Wednesday, January 30, 2013

Silibinin, found in milk thistle, protects against UV-induced skin cancer




A pair of University of Colorado Cancer Center studies published this month show that the milk thistle extract, silibinin, kills skin cells mutated by UVA radiation and protects against damage by UVB radiation – thus protecting against UV-induced skin cancer and photo-aging.

“When you have a cell affected by UV radiation, you either want to repair it or kill it so that it cannot go on to cause cancer. We show that silibinin does both,” says Rajesh Agarwal, PhD, co-program leader of Cancer Prevention and Control at the CU Cancer Center and professor at the Skaggs School of Pharmacy and Pharmaceutical Sciences.

The first study, published in the journal Photochemistry and Photobiology worked with human skin cells subjected to UVA radiation, which makes up about 95 percent of the sun’s radiation that reaches Earth. The Agarwal Lab treated these UVA-affected cells with silibinin. With silibinin, the rate at which these damaged cells died increased dramatically.

“When you take human skin cells – keratinocytes – and treat them with silibinin, nothing happens. It’s not toxic. But when you damage these cells with UVA radiation, treatment with silibinin kills the cells,” Agarwal says, thus removing the mutated cells that can cause skin cancer and photo-aging.

Specifically, the study shows that pretreatment with silibinin resulted in higher release of reactive oxygen species (ROS) within the UVA-exposed cells, leading to higher rates of cell death.

The second study, published this month by the same authors in the journal Molecular Carcinogenesis shows that instead of beneficially killing cells damaged by UVA radiation, treatment with silibinin protects human skill cells from damage by UVB radiation, which makes up about 5 percent of the sun’s radiation reaching Earth.

Again, remember Agarwal’s suggestion that the prevention of UV-induced skin cancer can happen in two ways: by protecting against DNA damage or by killing cells with damaged DNA. With UVA, silibinin kills; with UVB, it protects, in this case by increasing cells’ expression of the protein interleukin-12, which works to quickly repair damaged cells.

“It has been 20 years of work with this compound, silibinin,” Agarwal says. “We first noticed its effectiveness in treating both skin and solid cancers, and we now have a much more complete picture of the mechanisms that allow this compound to work.”

Agarwal and colleagues continue to test the effectiveness of silibinin in cancer prevention and treatment in cell lines and mouse models, and are working toward human trials of silibinin-based therapeutics.

Tuesday, January 29, 2013

Jon's Health Tips

Here's the latest report on why I avoid eating deep-fried food:

Eating deep-fried food = increased risk of prostate cancer


Regular consumption of deep-fried foods such as French fries, fried chicken and doughnuts is associated with an increased risk of prostate cancer..
While previous studies have suggested that eating foods made with high-heat cooking methods, such as grilled meats, may increase the risk of prostate cancer, this is the first study to examine the addition of deep frying to the equation...
Men who reported eating French fries, fried chicken, fried fish and/or doughnuts at least once a week were at an increased risk of prostate cancer as compared to men who said they ate such foods less than once a month. In particular, men who ate one or more of these foods at least weekly had an increased risk of prostate cancer that ranged from 30 to 37 percent.

and eat a high fiber diet:

High Fiber Diet Prevents Prostate Cancer Progression


I need to move around even more at the office and at home, since I never go to a gym:

An active lifestyle approach, as opposed to structured exercise, may be just as beneficial in improving health outcomes, including preventing metabolic syndrome, high blood pressure, and high cholesterol.


I will continue to eat lots of these:

Eating bright-colored fruits and vegetables may prevent or delay ALS

Fruit and vegetable intake is associated with lower risk of breast cancer


More fruit and vegetables=calmer, happier, more energetic

Strawberries, blueberries may cut heart attack risk in women


Eating three or more servings of blueberries and strawberries per week may help women reduce their risk of a heart attack by as much as one-third, researchers reported (January, 2013) in Circulation: Journal of the American Heart Association.

Somethings for me to look forward to?

Diet may not impact certain health outcomes in older persons

Eating diets high in sugar and fat may not affect the health outcomes of older adults ages 75 and up.

It's True: Medical Cannabis Provides Dramatic Relief for Sufferers of Chronic Ailments

Using marijuana from a farm called Tikkun Olam — a reference to the Jewish concept of healing the world — Klein and his fellow researchers tested the impact of the treatment on 19 residents of the Hadarim nursing home in Israel. The results, Klein says, have been outstanding. Not only did participants experience dramatic physical results, including healthy weight gain and the reduction of pain and tremors, but Hadarim staff saw an immediate improvement in the participants' moods and communication skills. The use of chronic medications was also significantly reduced, he reports.

More things for me to worry about:

Don't ignore the snore: Snoring may be early sign of future health risks


Snoring may put you at a greater risk than those who are overweight, smoke or have high cholesterol.

Regular Aspirin Use Linked to Increased Risk of Age-Related Macular Degeneration

I wasn't happy about the threat of going blind so to reaffirm my resolve to continue taking aspirin I looked again at this summary:
Health Benefits of Aspirin


I avoid all soda and sweetened drinks:

Diet soda, sweetened drinks linked to depression risk


The risk appeared to be greater for people who drank diet than regular soda, diet than regular fruit punches and for diet than regular iced tea.

This is good news indeed - I will continue to drink red wine and white tea:


Red wine and green and white tea could give athletes and players a boost in the sports arena by increasing the amount of performance-enhancing hormone testosterone in their bodies.




More interesting reports:

Harms from breast cancer screening outweigh benefits


Which nutritional factors help preserve muscle mass in the elderly

Eating deep-fried food = increased risk of prostate cancer




Frequent, regular consumption has strongest effect and is linked to more aggressive disease

Regular consumption of deep-fried foods such as French fries, fried chicken and doughnuts is associated with an increased risk of prostate cancer, and the effect appears to be slightly stronger with regard to more aggressive forms of the disease, according to a study by investigators at Fred Hutchinson Cancer Research Center.

Corresponding author Janet L. Stanford, Ph.D., and colleagues Marni Stott-Miller, Ph.D., a postdoctoral research fellow and Marian Neuhouser, Ph.D., all of the Hutchinson Center’s Public Health Sciences Division, have published their findings online in The Prostate.

While previous studies have suggested that eating foods made with high-heat cooking methods, such as grilled meats, may increase the risk of prostate cancer, this is the first study to examine the addition of deep frying to the equation.

From French fries to doughnuts: Eating more than once a week may raise risk


Specifically, Stanford, co-director of the Hutchinson Center’s Program in Prostate Cancer Research, and colleagues found that men who reported eating French fries, fried chicken, fried fish and/or doughnuts at least once a week were at an increased risk of prostate cancer as compared to men who said they ate such foods less than once a month.

In particular, men who ate one or more of these foods at least weekly had an increased risk of prostate cancer that ranged from 30 to 37 percent. Weekly consumption of these foods was associated also with a slightly greater risk of more aggressive prostate cancer. The researchers controlled for factors such as age, race, family history of prostate cancer, body-mass index and PSA screening history when calculating the association between eating deep-fried foods and prostate cancer risk.

“The link between prostate cancer and select deep-fried foods appeared to be limited to the highest level of consumption – defined in our study as more than once a week – which suggests that regular consumption of deep-fried foods confers particular risk for developing prostate cancer,” Stanford said.

Deep frying may trigger formation of carcinogens in food

Possible mechanisms behind the increased cancer risk, Stanford hypothesizes, include the fact that when oil is heated to temperatures suitable for deep frying, potentially carcinogenic compounds can form in the fried food. They include acrylamide (found in carbohydrate-rich foods such as French fries), heterocyclic amines and polycyclic aromatic hydrocarbons (chemicals formed when meat is cooked at high temperatures), aldehyde (an organic compound found in perfume) and acrolein (a chemical found in herbicides). These toxic compounds are increased with re-use of oil and increased length of frying time.

Foods cooked with high heat also contain high levels of advanced glycation endproducts, or AGEs, which have been associated with chronic inflammation and oxidative stress. Deep-fried foods are among the highest in AGE content. A chicken breast deep fried for 20 minutes contains more than nine times the amount of AGEs as a chicken breast boiled for an hour, for example.

For the study, Stanford and colleagues analyzed data from two prior population-based case-control studies involving a total of 1,549 men diagnosed with prostate cancer and 1,492 age-matched healthy controls. The men were Caucasian and African-American Seattle-area residents and ranged in age from 35 to 74 years. Participants were asked to fill out a dietary questionnaire about their usual food intake, including specific deep-fried foods.

“To the best of our knowledge, this is the first study to look at the association between intake of deep-fried food and risk of prostate cancer,” Stanford said. However, deep-fried foods have previously been linked to cancers of the breast, lung, pancreas, head and neck, and esophagus.

Because deep-fried foods are primarily eaten outside the home, it is possible that the link between these foods and prostate cancer risk may be a sign of high consumption of fast foods in general, the authors wrote, citing the dramatic increase in fast-food restaurants and fast-food consumption in the U.S. in the past several decades.

STUDY: TAKING STAIRS, RAKING LEAVES MAY EQUAL A TRIP TO THE GYM


New research at Oregon State University suggests the health benefits of small amounts of activity – even as small as one- and two-minute increments that add up to 30 minutes per day – can be just as beneficial as longer bouts of physical exercise achieved by a trip to the gym.

The nationally representative study of more than 6,000 American adults shows that an active lifestyle approach, as opposed to structured exercise, may be just as beneficial in improving health outcomes, including preventing metabolic syndrome, high blood pressure, and high cholesterol.

“Our results suggest that engaging in an active lifestyle approach, compared to a structured exercise approach, may be just as beneficial in improving various health outcomes,” said Paul Loprinzi, lead author of the study. “We encourage people to seek out opportunities to be active when the choice is available. For example, rather than sitting while talking on the phone, use this opportunity to get in some activity by pacing around while talking.”

Perhaps just as importantly, the researchers found that 43 percent of those who participated in the “short bouts” of exercise met physical activity guidelines of 30 minutes day. In comparison, less than 10 percent of those in the longer exercise bouts met those federal guidelines for exercise.

Loprinzi, who is an assistant professor at Bellarmine University, conducted the research as a doctoral student working in the lab of Brad Cardinal at Oregon State University. Cardinal, a professor of exercise and sport science, is co-author of the study, which is in the current issue of the American Journal of Health Promotion.

“You hear that less than 10 percent of Americans exercise and it gives the perception that people are lazy,” Cardinal said. “Our research shows that more than 40 percent of adults achieved the exercise guidelines, by making movement a way of life.”

Cardinal, who has studied the “lifestyle exercise” model for more than 20 years, said one of the most common barriers people cite to getting enough exercise is lack of time. He said the results of this study are promising, and show that simply building movement into everyday activities can have meaningful health benefits.

“This is a more natural way to exercise, just to walk more and move around a bit more,” Cardinal said. “We are designed by nature as beings who are supposed to move. People get it in their minds, if I don’t get that 30 minutes, I might as well not exercise at all. Our results really challenge that perception and give people meaningful, realistic options for meeting the physical activity guidelines.”

For example, Cardinal said instead of driving half a mile, try biking or walking the same distance; instead of using a riding lawn mower, use a push lawn mower. Instead of sitting through TV commercials, try doing some sit-ups, push-ups, or jumping jacks during the commercial breaks; and instead of sitting and being a spectator at a child's sporting event, try walking around during the halftime break.

The researchers said the participants in this study wore accelerometers, which is an objective tool to measure physical activity. Those who participated in the short bouts of activity could be moving as few as one or two minutes at a time. The people in the “short bouts” group had positive results in areas such as blood pressure, cholesterol, metabolic syndrome, and waist circumference.

For instance, the study showed those in the shorter exercise group who met physical activity guidelines had an 89 percent chance of not having metabolic syndrome, compared to 87 percent for those meeting guidelines using the structured exercise approach.

Loprinzi said the one area where small bursts of activity did not seem to equal the benefits of longer, sustained exercise was in Body Mass Index, or BMI. However, the researchers cautioned that these findings do not necessarily mean that short bouts of activity do not help with weight loss, especially since they did find a benefit on weight circumference.

“There are inherent limitations in BMI as a surrogate measure of fat and health in general,” Cardinal said. “People can still be ‘fit’ and ‘fat.’”

The researchers emphasized that for health benefits, people should seek out opportunities to be physically active.

“In our society, you will always be presented with things that entice you to sit or be less active because of technology, like using a leaf blower instead of a rake,” Cardinal said. “Making physical activity a way of life is more cost-effective than an expensive gym membership. You may be more likely to stick with it, and over the long term, you’ll be healthier, more mobile and just feel better all around.”

Eating bright-colored fruits and vegetables may prevent or delay ALS



New research suggests that increased consumption of foods containing colorful carotenoids, particularly beta-carotene and lutein, may prevent or delay the onset of amyotrophic lateral sclerosis (ALS). The study, published by Wiley in Annals of Neurology, a journal of the American Neurological Association and Child Neurology Society, found that diets high in lycopene, beta-cryptoxanthin, and vitamin C did not reduce ALS risk.

Carotenoids give fruits and vegetables their bright orange, red, or yellow colors, and are a source of dietary vitamin A. Prior studies report that oxidative stress plays a role in the development of ALS. Further studies have shown that individuals with high intake of antioxidants, such as vitamin E, have a reduced ALS risk. Because vitamin C or carotenoids are also antioxidants, researchers examined their relation to ALS risk.

According to the National Institutes of Neurological Disorders and Stroke (NINDS) roughly 20,000 to 30,000 Americans have ALS—also known as Lou Gehrig's disease—and another 5,000 patients are diagnosed annually with the disease. ALS is a progressive neurological disease that attacks nerve cells (neurons) in the brain and spinal cord, which control voluntary muscles. As the upper and lower motor neurons degenerate, the muscles they control gradually weaken and waste away, leading to paralysis.

"ALS is a devastating degenerative disease that generally develops between the ages of 40 and 70, and affects more men than women," said senior author Dr. Alberto Ascherio, Professor of Epidemiology and Nutrition at Harvard School of Public Health in Boston, Mass. "Understanding the impact of food consumption on ALS development is important. Our study is one of the largest to date to examine the role of dietary antioxidants in preventing ALS."

Using data from five prospective groups: the National Institutes of Health (NIH)–AARP Diet and Health Study, the Cancer Prevention Study II-Nutrition Cohort, the Multiethnic Cohort, the Health Professionals Follow-up Study, and the Nurses' Health Study, researchers investigated more than one million participants for the present study. A total of 1093 ALS cases were identified after excluding subjects with unlikely food consumption.

The team found that a greater total carotenoid intake was linked to reduced risk of ALS. Individuals who consumed more carotenoids in their diets were more likely to exercise, have an advanced degree, have higher vitamin C consumption, and take vitamin C and E supplements. Furthermore, subjects with diets high in beta-carotene and lutein—found in dark green vegetables—had a lower risk ALS risk. Researchers did not find that lycopene, beta-cryptoxanthin, and vitamin C reduced the risk of ALS. Long-term vitamin C supplement intake was also not associated with lower ALS risk.

Dr. Ascherio concludes, "Our findings suggest that consuming carotenoid-rich foods may help prevent or delay the onset of ALS. Further food-based analyses are needed to examine the impact of dietary nutrients on ALS."

Thursday, January 24, 2013

Fruit and vegetable intake is associated with lower risk of ER- breast cancer


There is no association between total fruit and vegetable intake and risk of overall breast cancer, but vegetable consumption is associated with a lower risk of estrogen receptor-negative (ER-) breast cancer, according to a study published January 24 in the Journal of the National Cancer Institute.

The intake of fruits and vegetables has been hypothesized to lower breast cancer risk, however the existing evidence is inconclusive. There are many subtypes of breast cancer including ER- and ER positive (ER+) tumors and each may have distinct etiologies. Since ER- tumors, which have lower survival rates and are less dependent on estrogen levels than ER+ tumors, account for only 15-20% of breast cancers, large pooled analyses are needed to determine the suspected link to lower ER- breast cancer risk and the consumption of fruits and vegetables.

In order to determine if there is a link between the lowered risk of ER- breast cancers and the intake of fruits and vegetables, Seungyoun Jung, Sc.D., formerly from the Department of Nutrition, Harvard School of Public Health, and currently at the Channing Division of Network Medicine, Brigham and Women's Hospital, and colleagues analyzed data from 20 cohort studies of women who were followed for a maximum of 11-20 years. They investigated the association of high compared to low intake of fruit and vegetables and risk of developing breast cancer in each study and then combined the study-specific estimates to generate summary estimates for all studies combined.

The researchers found that total fruit and vegetable intake was statistically significantly linked to a lower risk of ER- breast cancer, but not with risk of overall breast cancer or risk of ER+ breast tumors. The results showed that the lower risk was mostly associated with higher vegetable consumption. "These findings support the value of examining etiologic factors in relation to breast cancer characterized by hormone receptor status in large pooled analyses because modest associations with less common breast cancer subtypes may have been missed in smaller studies," the authors write.

In an accompanying editorial, Cynthia A. Thomson, Ph.D., and Patricia A. Thompson, Ph.D., both of the University of Arizona Cancer Center, write that the findings of the study support the emphasis on greater intake for vegetables (and to a lesser extent fruit) to lower the risk of ER- breast cancer. However, they also write that, "interpretation of these findings may also be challenged by the known effects of other potential confounders, including the aggregation of health behaviors."

Harms from breast cancer screening outweigh benefits if death caused by treatment is included


Michael Baum, Professor emeritus of surgery at University College London says that, while deaths from breast cancer may be avoided, any benefit will be more than outweighed by deaths due to the long term adverse effects of treatment.

He estimates that, for every 10, 000 women invited for screening, three to four breast cancer deaths are avoided at the cost of 2.72 to 9.25 deaths from the long term toxicity of radiotherapy.

These figures contrast with an independent report on breast cancer screening, led by Sir Michael Marmot and published in November last year. Marmot and his committee were charged with asking whether the screening programme should continue, and if so, what women should be told about the risks of overdiagnosis.

They concluded that screening should continue because it prevented 43 deaths from breast cancer for every 10,000 women invited for screening.

The downside was an estimated 19% rate of overdiagnosis: 129 of the 681 cancers detected in those 10,000 women would have done them no harm during their lifetime. However, those women would have undergone unnecessary treatment, including surgery, radiotherapy and chemotherapy.

But despite this higher than previous estimate of overdiagnosis, they concluded that the breast screening programme should continue.

The report also judged that screening reduces the risk of dying from breast cancer by 20%. But Professor Baum disputes these figures, saying the analysis takes no account of improvements in treatment since these trials were done, which will reduce the benefits of screening. Nor does it make use of more recent observational data.

With these data included, estimated rates of overdiagnosis as a result of screening increase to up to 50%, he argues.

This is important because it can change the decisions women make when invited for screening. In a study also published today, researchers at the University of Sydney explored attitudes to screening in a sample of 50 women. Many of the women were surprised when they were told about overdiagnosis and most said they would attend screening if overdiagnosis rates were 30% or lower, but a rate of 50% made most of them reconsider.

An accompanying editorial points out that the harms of screening will reduce as more effective diagnostic processes develop to inform less harmful and more personalised treatments. In the meantime, it says women need up to date and transparent information about the benefits and harms of screening to help them make informed choices.

It's True: Medical Cannabis Provides Dramatic Relief for Sufferers of Chronic Ailments



Treatment can improve appetite, ease chronic pain, and more


Though controversial, medical cannabis has been gaining ground as a valid therapy, offering relief to suffers of diseases such as cancer, Post-Traumatic Stress Disorder, ALS and more. The substance is known to soothe severe pain, increase the appetite, and ease insomnia where other common medications fail.

In 2009, Zach Klein, a graduate of Tel Aviv University's Department of Film and Television Studies, directed the documentary Prescribed Grass. Through the process, he developed an interest in the scientific research behind medical marijuana, and now, as a specialist in policy-making surrounding medical cannabis and an MA student at TAU's Porter School of Environmental Studies, he is conducting his own research into the benefits of medical cannabis.

Using marijuana from a farm called Tikkun Olam — a reference to the Jewish concept of healing the world — Klein and his fellow researchers tested the impact of the treatment on 19 residents of the Hadarim nursing home in Israel. The results, Klein says, have been outstanding. Not only did participants experience dramatic physical results, including healthy weight gain and the reduction of pain and tremors, but Hadarim staff saw an immediate improvement in the participants' moods and communication skills. The use of chronic medications was also significantly reduced, he reports.

Klein's research team includes Dr. Dror Avisar of TAU's Hydrochemistry Laboratory at the Department of Geography and Human Environment; Prof. Naama Friedmann and Rakefet Keider of TAU's Jaime and Joan Constantiner School of Education; Dr. Yehuda Baruch of TAU's Sackler Faculty of Medicine and director of the Abarbanel Mental Health Center; and Dr. Moshe Geitzen and Inbal Sikorin of Hadarim.

Cutting down on chronic medications

Israel is a world leader in medical cannabis research, Klein says. The active ingredient in marijuana, THC, was first discovered there by Profs. Raphael Mechoulam and Yechiel Gaoni. Prof. Mechoulam is also credited for having defined the endocannabinoid system, which mimics the effects of cannabis and plays a role in appetite, pain sensation, mood and memory.

In the Hadarim nursing home, 19 patients between the ages of 69 and 101 were treated with medical cannabis in the form of powder, oil, vapor, or smoke three times daily over the course of a year for conditions such as pain, lack of appetite, and muscle spasms and tremors. Researchers and nursing home staff monitored participants for signs of improvement, as well as improvement in overall life quality, such as mood and ease in completing daily living activities.

During the study, 17 patients achieved a healthy weight, gaining or losing pounds as needed. Muscle spasms, stiffness, tremors and pain reduced significantly. Almost all patients reported an increase in sleeping hours and a decrease in nightmares and PTSD-related flashbacks.

There was a notable decline in the amount of prescribed medications taken by patients, such as antipsychotics, Parkinson's treatment, mood stabilizers, and pain relievers, Klein found, noting that these drugs have severe side effects. By the end of the study, 72 percent of participants were able to reduce their drug intake by an average of 1.7 medications a day.

Connecting cannabis and swallowing

This year, Klein is beginning a new study at Israel's Reuth Medical Center with Drs. Jean-Jacques Vatine and Aviah Gvion, in which he hopes to establish a connection between medical cannabis and improved swallowing. One of the biggest concerns with chronically ill patients is food intake, says Klein. Dysphagia, or difficulty in swallowing, can lead to a decline in nutrition and even death. He believes that cannabis, which has been found to stimulate regions of the brain associated with swallowing reflexes, will have a positive impact.

Overall, Klein believes that the healing powers of cannabis are close to miraculous, and has long supported an overhaul in governmental policy surrounding the drug. Since his film was released in 2009, the number of permits for medical cannabis in Israel has increased from 400 to 11,000. His research is about improving the quality of life, he concludes, especially for those who have no other hope.

Don't ignore the snore: Snoring may be early sign of future health risks


Here's a wake-up call for snorers: Snoring may put you at a greater risk than those who are overweight, smoke or have high cholesterol to have thickening or abnormalities in the carotid artery, according to researchers at Henry Ford Hospital in Detroit.

The increased thickening in the lining of the two large blood vessels that supply the brain with oxygenated blood is a precursor to atherosclerosis, a hardening of the arteries responsible for many vascular diseases.

"Snoring is more than a bedtime annoyance and it shouldn't be ignored. Patients need to seek treatment in the same way they would if they had sleep apnea, high blood pressure or other risk factors for cardiovascular disease," says lead study author Robert Deeb, M.D., with the Department of Otolaryngology-Head & Neck Surgery at Henry Ford.

"Our study adds to the growing body of evidence suggesting that isolated snoring may not be as benign as first suspected. So instead of kicking your snoring bed partner out of the room or spending sleepless nights elbowing him or her, seek out medical treatment for the snorer."

The study reveals changes in the carotid artery with snorers – even for those without sleep apnea – likely due to the trauma and subsequent inflammation caused by the vibrations of snoring.

Study results will be presented Friday at the 2013 Combined Sections Meeting of the Triological Society in Scottsdale, Ariz. It has been submitted to The Laryngoscope journal for publication.

Obstructive sleep apnea (OSA) – a sleep disorder that occurs due to the collapse of the airway in the throat during sleep and causes loud snoring and periodic pauses in breathing – has long been linked to cardiovascular disease, along with a host of other serious health issues.

But the risk for cardiovascular disease may actually begin with snoring, long before it becomes OSA. Until now, there was little evidence in humans to show a similar connection between snoring and cardiovascular risk.

For the Henry Ford study, Dr. Deeb and senior study author Kathleen Yaremchuk, M.D., reviewed data for 913 patients who had been evaluated by the institution's sleep center.

Patients, ages 18-50, who had participated in a diagnostic sleep study between December 2006 and January 2012 were included in the study. None of the participants had sleep apnea.

In all, 54 patients completed the snore outcomes survey regarding their snoring habits, as well as underwent a carotid artery duplex ultrasound to measure the intima-media thickness of the carotid arteries.

Carotid intima-media thickness, a measurement of the thickness of the innermost two layers of the arterial wall, may be used to detect the presence and to track the progression of atherosclerotic disease. Intima-media thickness is the first sign of carotid artery disease.

Compared to non-snorers, snorers were found to have a significantly greater intima-media thickness of the carotid arteries, the study finds.

The study also revealed no statistically significant differences in intima-media thickness for patients with or without some of the traditional risk factors for cardiovascular disease – smoking, diabetes, hypertension or hypercholesterolemia.

"Snoring is generally regarded as a cosmetic issue by health insurance, requiring significant out-of-pocket expenses by patients. We're hoping to change that thinking so patients can get the early treatment they need, before more serious health issues arise."

The Henry Ford research team plans to conduct another long-term study on this topic, particularly to determine if there's an increased incidence of cardiovascular events in patients who snore.

A blend of soy and dairy proteins promotes muscle protein synthesis



A new study published in The Journal of Nutrition demonstrates the benefits of consuming a protein blend for muscle protein synthesis after exercise. This study is a first-of-its-kind, conducted by researchers at the University of Texas Medical Branch, and utilizes the proteins from soy, whey and casein consumed after an acute bout of resistance exercise. These proteins have complementary amino acid profiles and different digestion rates (amino acid release profiles). The results demonstrate prolonged delivery of amino acids to muscles and extended muscle protein synthesis when subjects consumed the blend, compared to a single source of protein alone.

"Sources of high-quality protein contain all the essential amino acids and have individual characteristics thought to offer a unique advantage for muscle growth," said Blake Rasmussen, Ph.D., interim chair, Department of Nutrition & Metabolism and principal investigator of the study. "This is the first study to test the effects of combining soy with the dairy proteins, whey and casein, for promotion of lean body mass gain."

The composition of the blend used in the current study was based on results from a recently published pre-clinical study that demonstrated enhanced postprandial skeletal muscle protein synthesis in rats compared to another blend of soy or whey protein sources alone. This human clinical study for the first time shows that a soy-dairy protein blend (25 percent SUPRO® isolated soy protein, 25 percent whey protein isolate and 50 percent caseinate) is capable of stimulating muscle growth to a similar extent as whey protein through an elevation in muscle protein synthesis and muscle cell growth signaling. In addition, the blend extended the anabolic window (i.e., prolonged increase in the rate of muscle protein synthesis from rest) for a longer amount of time than whey alone.

The beverages provided approximately 20 grams of protein from either the soy-dairy blend or whey protein and contained similar amounts of leucine, a key amino acid involved in muscle cell signaling pathways that regulate muscle protein synthesis rates. The beverages were consumed following high-intensity leg resistance exercise. Multiple leg muscle samples were collected from each subject to determine changes in muscle protein synthesis over time (at rest and 3 and 5 hours after exercise). Nineteen healthy, young adults participated in the randomized, double blind trial.

"Previous research examines only single sources of proteins and does not match the protein sources for leucine content, a branched chain amino acid with anabolic effects, thought to trigger muscle protein synthesis. Results from our study with matched leucine indicate the soy-dairy protein blend stimulated muscle synthesis during the early recovery period as well as into the later post-exercise period, compared to the single protein treatment, whey, which only increased muscle synthesis from rest into the early recovery period," said Paul Reidy, lead investigator on the study.

Proteins from milk (casein and whey), soy, beef and egg are effective in stimulating post-exercise muscle protein synthesis. This study demonstrates that consumption of a beverage made with a soy-dairy protein blend following exercise is capable of prolonging amino acid delivery to muscles, muscle cell signaling and protein synthesis in human skeletal muscle. This extension of the anabolic window may also be important for the aging muscle.

"No research on blends of proteins from different sources and their effects on muscle protein synthesis has been done, to-date. Muscle health is of great concern to not only young and active individuals like the ones in this study but also to the aging population. The role of protein for muscle health is a key area of interest for our company, " said Ratna Mukherjea, Ph.D., Nutrition Science team lead at Solae/DuPont Nutrition & Health. "This publication expands on results indicating the beneficial effects of consuming blends shared at numerous scientific meetings in 2012."

Low vitamin D levels linked to high risk of premenopausal breast cancer



A prospective study led by researchers from the University of California, San Diego School of Medicine has found that low serum vitamin D levels in the months preceding diagnosis may predict a high risk of premenopausal breast cancer.

The study of blood levels of 1,200 healthy women found that women whose serum vitamin D level was low during the three-month period just before diagnosis had approximately three times the risk of breast cancer as women in the highest vitamin D group. The study is currently published online in advance of the print edition of the journal Cancer Causes and Control.

Several previous studies have shown that low serum levels of vitamin D are associated with a higher risk of premenopausal breast cancer. "While the mechanisms by which vitamin D could prevent breast cancer are not fully understood, this study suggests that the association with low vitamin D in the blood is strongest late in the development of the cancer, "said principal investigator Cedric Garland, DrPH, FACE, professor in the Department of Family and Preventive Medicine at UC San Diego.

Analyses of vitamin D levels measured more than 90 days before diagnosis have not conclusively established a relationship between serum levels and risk of premenopausal breast cancer in the present cohort. However, this new study points to the possibility of a relevant window of time for cancer prevention in the last three months preceding tumor diagnosis –a time physiologically critical to the growth of the tumor.

According to Garland, this is likely to be the point at which the tumor may be most actively recruiting blood vessels required for tumor growth. "Based on these data, further investigation of the role of vitamin D in reducing incidence of premenopausal breast cancer, particularly during the late phases of its development, is warranted," he said.

The new study drew upon 9 million blood serum specimens frozen by the Department of Defense Serum Repository for routine disease surveillance. The researchers thawed and analyzed pre-diagnostic samples of serum from 1,200 women whose blood was drawn in the same time frame – samples from 600 women who later developed breast cancer, and from 600 women who remained healthy.

A 2011 meta-analysis by Garland and colleagues estimated that a serum level of 50 ng/ml is associated with 50 percent lower risk of breast cancer. While there are some variations in absorption, those who consume 4000 IU per day of vitamin D from food or a supplement normally would reach a serum level of 50 ng/ml.

Garland added that a consensus of all available data has shown no known risk associated with this concentration of vitamin D, which is measured as serum 25-hydroxyvitamin D. But he urges patients to ask their health care provider to measure their serum 25(OH)D before substantially increasing vitamin D intake.

"Reliance should not be placed on different forms of vitamin D, such as vitamin D2, and megadoses should be avoided except those ordered by a doctor for short-term use," Garland added.

Health Benefits of Aspirin: Latest Health Research


See update here:

http://healthnewsreport.blogspot.com/2013/10/health-benefits-of-aspirin-updated.html

More fruit and vegetables=calmer, happier, more energetic

Eating more fruit and vegetables may make young people calmer, happier and more energetic in their daily life, new research from the University of Otago suggests.

Department of Psychology researcher Dr Tamlin Conner, and Dr Caroline Horwath and Bonnie White from Otago's Department of Human Nutrition, investigated the relationship between day-to-day emotions and food consumption.

The study is published in the British Journal of Health Psychology on January 24.

A total of 281 young adults (with a mean age of 20 years) completed an internet-based daily food diary for 21 consecutive days. Prior to this, participants completed a questionnaire giving details of their age, gender, ethnicity, weight and height. Those with a history of an eating disorder were excluded.

On each of the 21 days participants logged into their diary each evening and rated how they felt using nine positive and nine negative adjectives. They were also asked five questions about what they had eaten that day. Specifically, participants were asked to report the number of servings eaten of fruit (excluding fruit juice and dried fruit), vegetables (excluding juices), and several categories of unhealthy foods like biscuits/cookies, potato crisps, and cakes/muffins.

The results showed a strong day-to-day relationship between more positive mood and higher fruit and vegetable consumption, but not other foods.

"On days when people ate more fruits and vegetables, they reported feeling calmer, happier and more energetic than they normally did," says Dr Conner.

To understand which comes first -- feeling positive or eating healthier foods -- Dr Conner and her team ran additional analyses and found that eating fruits and vegetables predicted improvements in positive mood the next day, suggesting that healthy foods may improve mood. These findings held regardless of the BMI of individuals.

"After further analysis we demonstrated that young people would need to consume approximately seven to eight total servings of fruits and vegetables per day to notice a meaningful positive change. One serving of fruit or vegetables is approximately the size that could fit in your palm, or half a cup. My co-author Bonnie White suggests that this can be done by making half your plate at each meal vegetables and snacking on whole fruit like apples," says Dr Conner.

She adds that while this research shows a promising connection between healthy foods and healthy moods, further research is necessary and the authors recommend the development of randomised control trials evaluating the influence of high fruit and vegetable intake on mood and wellbeing.

Tuesday, January 22, 2013

Regular Aspirin Use Linked to Increased Risk of Age-Related Macular Degeneration


Regular aspirin use appears to be associated with an increased risk of neovascular age-related macular degeneration (AMD), which is a leading cause of blindness in older people, and it appears to be independent of a history of cardiovascular disease and smoking, according to a report published Online First by JAMA Internal Medicine.

Aspirin is one of the most widely used medications in the world and is commonly used in the prevention of cardiovascular disease, such as myocardial infarction (heart attack) and ischemic stroke. While a recent study suggested that regular aspirin use was associated with AMD, particularly the more visually devastating neovascular (wet) form, other studies have reported inconsistent findings. Smoking is also a preventable risk factor for AMD, the authors write in the study background.

Gerald Liew, Ph.D., of the University of Sydney, Australia, and colleagues examined whether regular aspirin use (defined as once or more per week in the past year) was associated with a higher risk of developing AMD by conducting a prospective analysis of data from an Australian study that included four examinations during a 15-year period. Of 2,389 participants, 257 individuals (10.8 percent) were regular aspirin users.

After the 15-year follow-up, 63 individuals (24.5 percent) developed incident neovascular AMD, according to the results.

"The cumulative incidence of neovascular AMD among nonregular aspirin users was 0.8 percent at five years, 1.6 percent at 10 years, and 3.7 percent at 15 years; among regular aspirin users, the cumulative incidence was 1.9 percent at five years, 7 percent at 10 years and 9.3 percent at 15 years, respectively," the authors note. "Regular aspirin use was significantly associated with an increased incidence of neovascular AMD."

The authors note that any decision concerning whether to stop aspirin therapy is "complex and needs to be individualized."

"Currently, there is insufficient evidence to recommend changing clinical practice, except perhaps in patients with strong risk factors for neovascular AMD (e.g., existing late AMD in the fellow eye) in whom it may be appropriate to raise the potentially small risk of incident neovascular AMD with long-term aspirin therapy," the authors conclude.

Commentary: Relationship of Aspirin Use with Age-Related Macular Degeneration

In an invited commentary, Sanjay Kaul, M.D., and George A. Diamond, M.D., of Cedars-Sinai Medical Center, Los Angeles, write: "This study has important strengths and limitations. It provides evidence from the largest prospective cohort with more than five years of longitudinal evaluation reported to date using objective and standardized ascertainment of AMD."

"The key limitation is the nonrandomized design of the study with its potential for residual (unmeasured or unobserved) confounding that cannot be mitigated by multivariate logistic regression or propensity score analysis," the authors continue.

"From a purely science-of-medicine perspective, the strength of evidence is not sufficiently robust to be clinically directive. These findings are, at best, hypothesis-generating that should await validation in prospective randomized studies before guiding clinical practice or patient behavior," the authors conclude. "However, from an art-of-medicine perspective, based on the limited amount of available evidence, there are some courses of action available to the thoughtful clinician. In the absence of definitive evidence regarding whether limiting aspirin exposure mitigates AMD risk, one obvious course of action is to maintain the status quo."

Monday, January 21, 2013

Which nutritional factors help preserve muscle mass, strength and performance in seniors?


Sarcopenia, or the gradual loss of muscle mass, is a common consequence of ageing, and poses a significant risk factor for disability in older adults. As muscle strength plays an important role in the tendency to fall, sarcopenia leads to an increased risk of fractures and other injuries.

The International Osteoporosis Foundation (IOF) Nutrition Working Group has published a new review which identifies nutritional factors that contribute to loss of muscle mass, or conversely, are beneficial to the maintenance of muscle mass. The Group reviewed evidence from worldwide studies on the role of nutrition in sarcopenia, specifically looking at protein, acid–base balance, vitamin D/calcium, and other minor nutrients like B vitamins.

“The most obvious intervention against sarcopenia is exercise in the form of resistance training,” said Professor Jean-Philippe Bonjour, co-author and Professor of Medicine at the Service of Bone Diseases, University of Geneva. “However, adequate nutritional intake and an optimal dietary acid-base balance are also very important elements of any strategy to preserve muscle mass and strength during ageing.”

The review discusses and identifies the following important nutritional factors that have been shown to be beneficial to the maintenance of muscle mass and the treatment and prevention of sarcopenia:

  • Protein: Protein intake plays an integral part in muscle health. The authors propose an intake of 1.0–1.2 g/kg of body weight per day as optimal for skeletal muscle and bone health in elderly people without severely impaired renal function.
  • Vitamin D: As many studies indicate a role for vitamin D in the development and preservation of muscle mass and function, adequate vitamin D should be ensured through exposure to sunlight and/or supplementation if required. Vitamin D supplementation in seniors, and especially in institutionalized elderly, is recommended for optimal musculoskeletal health.
  • Avoiding dietary acid loads: Excess intake of acid-producing nutrients (meat and cereal grains) in combination with low intake of alkalizing fruits and vegetables may have negative effects on musculoskeletal health. Modifying the diet to include more fruits and vegetables is likely to benefit both bones and muscles.

Emerging evidence also suggests that vitamin B12 and/or folic acid play a role in improving muscle function and strength.

As well, the Review discusses non-nutritional interventions such as hormones, and calls for more studies to identify the potential of antioxidants and anti-inflammatory compounds in the prevention of sarcopenia.

Dr. Ambrish Mithal, co-author and Chair and Head of Endocrinology and Diabetes division at Medanta, New Delhi underlined the need for further research in the field. “Strategies to reduce the numbers of falls and fractures within our ageing populations must include measures to prevent sarcopenia. At present, the available evidence suggests that combining resistance training with optimal nutritional status has a synergistic affect in preventing and treating sarcopenia, “ said Mithal.

“We hope that further studies will shed light on other effective ways of preventing and treating this condition.”


Reference:
Impact of nutrition on muscle mass, strength, and performance in older adults. A. Mithal & J.-P. Bonjour & S. Boonen & P. Burckhardt & H. Degens & G. El Hajj Fuleihan & R. Josse & P. Lips & J. Morales Torres & R. Rizzoli & N. Yoshimura & D. A. Wahl & C. Cooper & B. Dawson-Hughes & for the IOF CSA Nutrition Working Group. Osteoporos Int DOI 10.1007/s00198-012-2236-y
http://link.springer.com/article/10.1007/s00198-012-2236-y

Thursday, January 17, 2013

As colorectal cancer gets more aggressive, treatment with grape seed extract is even more effective



When the going gets tough, grape seed extract gets going: A University of Colorado Cancer Center study recently published in the journal Cancer Letters shows that the more advanced are colorectal cancer cells, the more GSE inhibits their growth and survival. On the other end of the disease spectrum, GSE leaves healthy cells alone entirely.

“We’ve known for quite a while that the bioactive compounds in grape seed extract selectively target many types of cancer cells. This study shows that many of the same mutations that allow colorectal cancer cells to metastasize and survive traditional therapies make them especially sensitive to treatment with GSE,” says Molly Derry, doctoral candidate in the lab of Rajesh Agarwal, PhD, investigator at the CU Cancer Center and professor at the Skaggs School of Pharmacy and Pharmaceutical Sciences.

Derry notes this is an especially important finding in light of increasing colorectal cancer rates (due in part to increasingly high-fat diets and sedentary lifestyles) and a low screening rate; that means 60 percent of patients diagnosed have already reached the advanced stage of the disease.

“Finding a way to selectively target advanced colorectal cancer cells could have major clinical importance,” Derry says.

The group performed their experiments on colorectal cancer cell lines representing various stages of the disease. Whereas it generally takes much more chemotherapy to kill a stage IV cancer cell than a stage II cancer cell, Derry saw that the reverse was true with grape seed extract.

“It required less than half the concentration of GSE to suppress cell growth and kill 50 percent of stage IV cells than it did to achieve similar results in the stage II cells,” Derry says.

The group also discovered a likely mechanism of GSE’s preferential targeting of advanced colorectal cancer cells: when cancer cells were treated with antioxidants the GSE induced cell death was reversed and so Derry and colleagues consider it likely that GSE targets colorectal cancer through inducing oxidative stress that leads to the programmed cell death known as apoptosis.

“A colorectal cancer cell can have upwards of 11,000 genetic mutations – differences from the DNA in healthy cells. Traditional chemotherapies may only target a specific mutation and as cancer progresses more mutations occur. These changes can result in cancer that is resistance to chemotherapy. In contrast, the many bioactive compounds of GSE are able to target multiple mutations. The more mutations a cancer presents, the more effective GSE is in targeting them,” Derry says.

Fast food diet linked to asthma and eczema severity in kids

Fast Food Diet Linked to Asthma and Eczema Severity in Kids, Large Study Finds


Eating three or more weekly servings of fast food is linked to the severity of allergic asthma, eczema, and rhinitis among children in the developed world, indicates a large international study published online in the respiratory journal Thorax.

The findings prompt the authors to suggest that a fast food diet may be contributing to the rise in these conditions, and if proved causal, could have huge implications for public health, given the popularity of these foodstuffs.

The authors base their findings on data from more than 319,000 13-14 year olds from 107 centres in 51 countries, and more than181,000 six to seven year olds from 64 centres in 31 countries.

All the participants were involved in the International Study of Asthma and Allergies in Childhood (ISAAC), which is a collaborative research project involving more than 100 countries and nearly two million children, making it the largest study of its kind.

The teens and the children's parents were formally quizzed on whether they had symptoms of asthma (wheeze); rhinoconjunctivitis (which produces a runny or blocked nose accompanied by itchy and watery eyes); and eczema; and their weekly diet.

Questions focused particularly on the severity of symptoms over the preceding 12 months -- including frequency and interference with daily life and/or sleep patterns -- and certain types of food already linked to protective or damaging effects on health

These included meat, fish, fruits and vegetables, pulses, cereals, bread and pasta, rice, butter, margarine, nuts, potatoes, milk, eggs, and fast food/burgers. Consumption was categorised as never; occasionally; once or twice a week; and three or more times a week.

After taking account of factors likely to influence the results, the analysis showed that fast food was the only food type to show the same associations across both age groups, prompting the authors to suggest that "such consistency adds some weight to the possible causality of the relationship."

It was associated with current and severe symptoms of all three conditions among the teens -- across all centres in the participating countries, irrespective of gender or levels of affluence.

The pattern among children was less clear-cut, but a fast food diet was still associated with symptoms across all centres -- except for current eczema -- and poorer countries -- except for current and severe asthma.

And this difference might have to do with the fact that children have fewer options about their food choices, suggest the authors.

Three or more weekly servings were linked to a 39% increased risk of severe asthma among teens and a 27% increased risk among children, as well as to the severity of rhinitis and eczema, overall.

On the other hand, fruit seemed to be protective in both age groups across all centres for all three conditions among children -- both current and severe -- and for current and severe wheeze and rhinitis among the teens.

Eating three or more weekly portions was linked to a reduction in symptom severity of between 11% and 14% among teens and children, respectively.

The authors suggest that there are plausible explanations for the findings: fast food contains high levels of saturated and trans fatty acids, which are known to affect immunity, while fruit is rich in antioxidants and other beneficial compounds.

The authors emphasise that their results do not prove cause and effect, but they do warrant further investigation.

"If the associations between fast foods and the symptom prevalence of asthma, rhinoconjunctivitis and eczema is causal, then the findings have major public health significance owing to the rising consumption of fast foods globally," they conclude.

Tuesday, January 15, 2013

Choline supplementation during pregnancy presents a new approach to schizophrenia prevention


Choline is also being studied for potential benefits in liver disease, including chronic hepatitis and cirrhosis, depression, memory loss, Alzheimer's disease and dementia, and certain types of seizures.

Choline, an essential nutrient similar to the B vitamin and found in foods such as liver, muscle meats, fish, nuts and eggs, when given as a dietary supplement in the last two trimesters of pregnancy and in early infancy, is showing a lower rate of physiological schizophrenic risk factors in infants 33 days old. The study breaks new ground both in its potentially therapeutic findings and in its strategy to target markers of schizophrenia long before the illness itself actually appears.

Robert Freedman, MD, professor and chairman of the Department of Psychiatry, University of Colorado School of Medicine and one of the study's authors and Editor of The American Journal of Psychiatry, points out, "Genes associated with schizophrenia are common, so prevention has to be applied to the entire population, and it has to be safe. Basic research indicates that choline supplementation during pregnancy facilitates cognitive functioning in offspring. Our finding that it ameliorates some of the pathophysiology associated with risk for schizophrenia now requires longer-term follow-up to assess whether it decreases risk for the later development of illness as well."

Normally, the brain responds fully to an initial clicking sound but inhibits its response to a second click that follows immediately. In schizophrenia patients, deficient inhibition is common and is related to poor sensory filtering and familial transmission of schizophrenia risk. Since schizophrenia does not usually appear until adolescence, this trait—measurable in infancy—was chosen to represent the illness.

Half the healthy pregnant women in this study took 3,600 milligrams of phosphatidylcholine each morning and 2,700 milligrams each evening; the other half took placebo. After delivery, their infants received 100 milligrams of phosphatidylcholine per day or placebo. Eighty-six percent of infants exposed to pre- and postnatal choline supplementation, compared to 43% of unexposed infants, inhibited the response to repeated sounds, as measured with EEG sensors placed on the baby's head during sleep.

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The study will be published online by The American Journal of Psychiatry (AJP) at AJP in Advance, its online-ahead-of-print website

Monday, January 14, 2013

Strawberries, blueberries may cut heart attack risk in women



Eating three or more servings of blueberries and strawberries per week may help women reduce their risk of a heart attack by as much as one-third, researchers reported (January, 2013) in Circulation: Journal of the American Heart Association.

Blueberries and strawberries contain high levels of naturally occurring compounds called dietary flavonoids, also found in grapes and wine, blackberries, eggplant, and other fruits and vegetables. A specific sub-class of flavonoids, called anthocyanins, may help dilate arteries, counter the buildup of plaque and provide other cardiovascular benefits, according to the study.

"Blueberries and strawberries can easily be incorporated into what women eat every week," said Eric Rimm D.Sc., senior author and Associate Professor of Nutrition and Epidemiology at the Harvard School of Public Health in Boston, Mass. "This simple dietary change could have a significant impact on prevention efforts."

Blueberries and strawberries were part of this analysis simply because they are the most-eaten berries in the United States. Thus, it's possible that other foods could produce the same results, researchers said.

Scientists from the Harvard School of Public Health in the United States and the University of East Anglia, United Kingdom conducted a prospective study among 93,600 women ages 25 to 42 who were registered with the Nurses' Health Study II. The women completed questionnaires about their diet every four years for 18 years.

During the study, 405 heart attacks occurred. Women who ate the most blueberries and strawberries had a 32-percent reduction in their risk of heart attack compared to women who ate the berries once a month or less – even in women who otherwise ate a diet rich in other fruits and vegetables.

"We have shown that even at an early age, eating more of these fruits may reduce risk of a heart attack later in life," said Aedín Cassidy, Ph.D., lead author and head of the Department of Nutrition at Norwich Medical School of the University of East Anglia in Norwich, United Kingdom.

The findings were independent of other risk factors, such as age, high blood pressure, family history of heart attack, body mass, exercise, smoking, caffeine or alcohol intake.

The American Heart Association supports eating berries as part of an overall balanced diet that also includes other fruits, vegetables and whole-grain products. Eating a variety of foods is the best way to get the right amounts of nutrients.

Diet may not impact certain health outcomes in older persons



Eating diets high in sugar and fat may not affect the health outcomes of older adults ages 75 and up, suggesting that placing people of such advanced age on overly restrictive diets to treat their excess weight or other conditions may have little benefit, according to researchers at Penn State and Geisinger Healthcare System.

"Historically people thought of older persons as tiny and frail," said Gordon Jensen, head of the Department of Nutritional Sciences at Penn State, "but that paradigm has changed for many older persons. Currently, 30 percent or more may be overweight, and by 2030, almost 30 percent are projected to be obese, not just overweight. Recent reports even suggest that there may be survival benefits associated with overweight and mild obesity status among the elderly."

"We all know that adverse dietary patterns, such as a Western diet containing high amounts of fat or a diet containing high amounts of refined sugar, both of which may contribute to obesity, are associated with adverse medical conditions and health outcomes for many people, but until now, the health effects of these types of poor diets have not been characterized for people who live to 75 years of age and older," said Pao Ying Hsao, postdoctoral fellow at Penn State.

The team's research is part of a decades-long collaborative study between Penn State and the Geisinger Healthcare System on the effects of nutritional status and diet on the health of more than 20,000 older people living in Pennsylvania. In the current study, the team followed 449 individuals for five years who were on average 76.5 years old at the beginning of the study.

"This is one of the first studies to examine obesity-related health outcomes and dietary patterns in such aged persons," Jensen said.

At study baseline, the team assessed the participants' dietary patterns by calling each of them by telephone four or five times during a 10-month period and asking them about their diets over the previous 24 hours. The participants were categorized as adhering to one of three different dietary patterns. The "sweets and dairy" pattern was characterized by the largest proportions of energy from baked goods, milk, sweetened coffee and tea and dairy-based desserts, and the lowest intakes of poultry. The "health-conscious" pattern was characterized by relatively higher intakes of pasta, noodles, rice, whole fruit, poultry, nuts, fish and vegetables, and lower intakes of fried vegetables, processed meats and soft drinks. The "Western" pattern was characterized by higher intakes of bread, eggs, fats, fried vegetables, alcohol and soft drinks, and the lowest intakes of milk and whole fruit.

Using outpatient electronic medical records, the researchers identified whether the participants developed cardiovascular disease, diabetes mellitus, hypertension (high blood pressure) and metabolic syndrome during the five-year period. They found no relationship between dietary pattern and prevalence of cardiovascular disease, diabetes, metabolic syndrome or mortality in the participants; however, they did find an increased risk of hypertension in people who followed the "sweets and dairy" pattern.

The results appeared in this month's issue of the Journal of Nutrition Health and Aging.

"We don't know if the participants had been following these dietary patterns their entire adult lives, but we suspect they had been because people don't usually change dietary practices all that much," Jensen said. "The results suggest that if you live to be this old, then there may be little to support the use of overly restrictive dietary prescriptions, especially where food intake may already be inadequate. However, people who live on prudent diets all their lives are likely to have better health outcomes."

Friday, January 11, 2013

Foods Identified as 'Whole Grain' Not Always Healthy


Current standards for classifying foods as "whole grain" are inconsistent and, in some cases, misleading, according to a new study by Harvard School of Public Health (HSPH) researchers. One of the most widely used industry standards, the Whole Grain Stamp, actually identified grain products that were higher in both sugars and calories than products without the Stamp. The researchers urge adoption of a consistent, evidence-based standard for labeling whole grain foods to help consumers and organizations make healthy choices. This is the first study to empirically evaluate the healthfulness of whole grain foods based on five commonly used industry and government definitions.

"Given the significant prevalence of refined grains, starches, and sugars in modern diets, identifying a unified criterion to identify higher quality carbohydrates is a key priority in public health," said first author Rebecca Mozaffarian, project manager in the Department of Social and Behavioral Sciences at HSPH.

The study appears in the January 4, 2013 advanced online edition of Public Health Nutrition.

The health benefits of switching from refined to whole grain foods are well established, including lower risk of cardiovascular disease, weight gain, and type 2 diabetes. Based on this evidence, the U.S. Department of Agriculture's (USDA) 2010 Dietary Guidelines recommend that Americans consume at least three servings of whole grain products daily, and the new U.S. national school lunch standards require that at least half of all grains be whole grain-rich. However, no single standard exists for defining any product as a "whole grain."

Mozaffarian and her colleagues assessed five different industry and government guidelines for whole grain products:

* The Whole Grain Stamp, a packaging symbol for products containing at least 8 grams of whole grains per serving (created by the Whole Grain Council, a non-governmental organization supported by industry dues)
* Any whole grain as the first listed ingredient (recommended by the USDA's MyPlate and the Food and Drug Administration's Consumer Health Information guide)
* Any whole grain as the first ingredient without added sugars in the first three ingredients (also recommended by USDA's MyPlate)
* The word "whole" before any grain anywhere in the ingredient list (recommended by USDA's Dietary Guidelines for Americans 2010)
* The "10:1 ratio," a ratio of total carbohydrate to fiber of less than 10 to 1, which is approximately the ratio of carbohydrate to fiber in whole wheat flour (recommended by the American Heart Association's 2020 Goals)

From two major U.S. grocers, the researchers identified a total of 545 grain products in eight categories: breads, bagels, English muffins, cereals, crackers, cereal bars, granola bars, and chips. They collected nutrition content, ingredient lists, and the presence or absence of the Whole Grain Stamp on product packages from all of these products.

They found that grain products with the Whole Grain Stamp, one of the most widely-used front-of-package symbols, were higher in fiber and lower in trans fats, but also contained significantly more sugar and calories compared to products without the Stamp. The three USDA recommended criteria also had mixed performance for identifying healthier grain products. Overall, the American Heart Association's standard (a ratio of total carbohydrate to fiber of ≤10:1) proved to be the best indicator of overall healthfulness. Products meeting this ratio were higher in fiber and lower in trans fats, sugar, and sodium, without higher calories than products that did not meet the ratio.

"Our results will help inform national discussions about product labeling, school lunch programs, and guidance for consumers and organizations in their attempts to select whole grain products," said senior author Steven Gortmaker, professor of the practice of health sociology.

Thursday, January 10, 2013

Marriage linked to better survival in middle age



Study highlights importance of social ties during midlife


Could marriage, and associated companionship, be one key to a longer life? According to new research, not having a permanent partner, or spouse, during midlife is linked to a higher risk of premature death during those midlife years. The work, by Dr. Ilene Siegler and colleagues from Duke University Medical Center in the US, is published online in Springer's journal Annals of Behavioral Medicine.

Survival through middle age to become elderly is expected; therefore understanding who does not survive to become elderly and why is important. Siegler and colleagues looked at the effect of marriage history and timing of marriage on premature death during midlife. They were also interested in testing the role of pre-marital personality and quantifying the role of health behaviors.

The researchers analyzed data for 4,802 individuals who took part in the University of North Carolina Alumni Heart Study (UNCAHS) - an ongoing study of individuals born in the 1940s. The authors were particularly interested in stability and change in patterns of marital and non-marital status during midlife, controlling for personality at college entry (average age 18), socioeconomic status and health risk behaviors.

They found that having a partner during middle age is protective against premature death: those who never married were more than twice as likely to die early than those who had been in a stable marriage throughout their adult life. Being single, or losing a partner without replacement, increased the risk of early death during middle age and reduced the likelihood that one would survive to be elderly. Even when personality and risky behaviors were taken into account, marital status continued to have a major impact on survival.

The authors conclude: "Our results suggest that attention to non-marital patterns of partnership is likely to become more important for these Baby Boomers. These patterns appear to provide different levels of emotional and functional social support, which has been shown to be related to mortality. Social ties during midlife are important to help us understand premature mortality."
Reference:
Siegler IC et al (2012). Consistency and timing of marital transitions and survival during midlife: the role of personality and health risk behaviors. Annals of Behavioral Medicine; DOI 10.1007/s12160-012-9457-3

STUDY DEFLATES NOTION THAT PEAR-SHAPED BODIES MORE HEALTHY THAN APPLES



People who are “apple-shaped” — with fat more concentrated around the abdomen — have long been considered more at risk for conditions such as heart disease and diabetes than those who are “pear-shaped” and carry weight more in the buttocks, hips and thighs.

But new research conducted at UC Davis Health System published in The Journal of Clinical Endocrinology and Metabolism provides further evidence that the protective benefits of having a pear-body shape may be more myth than reality. The journal article posted online January 10 and will appear in the March 2013 print edition.

The UC Davis study found that fat stored in the buttock area — also known as gluteal adipose tissue — secretes abnormal levels of chemerin and omentin-1, proteins that can lead to inflammation and a prediabetic condition know as insulin resistance in individuals with early metabolic syndrome.

Metabolic syndrome refers to a group of risk factors that occur together, doubling the risk for heart disease and increasing the risk for diabetes at least five-fold. Risk factors include having a large waistline, low levels of high-density lipoproteins (HDL), or “good” cholesterol, high blood pressure as well as high fasting blood sugar ( insulin resistance) and high triglyceride levels. According to the Centers for Disease Control and Prevention, metabolic syndrome affects 35 percent of American adults over age 20.

“Fat in the abdomen has long been considered the most detrimental to health, and gluteal fat was thought to protect against diabetes, heart disease and metabolic syndrome,” said Ishwarlal Jialal, lead author of the study and a professor of pathology and laboratory medicine and of internal medicine at UC Davis. ”But our research helps to dispel the myth that gluteal fat is ‘innocent.’ It also suggests that abnormal protein levels may be an early indicator to identify those at risk for developing metabolic syndrome.”

The UC Davis team found that in individuals with early metabolic syndrome, gluteal fat secreted elevated levels of chemerin and low levels of omentin-1 — proteins that correlate with other factors known to increase the risk for heart disease and diabetes. High chemerin levels, for example, correlated with high blood pressure, elevated levels of C-reactive protein (a sign of inflammation) and triglycerides, insulin resistance, and low levels of HDL cholesterol. Low omentin-1 levels correlated with high levels of triglycerides and blood glucose levels and low levels of HDL cholesterol.

“High chemerin levels correlated with four of the five characteristics of metabolic syndrome and may be a promising biomarker for metabolic syndrome,” said Jialal. “As it’s also an indicator of inflammation and insulin resistance, it could also emerge as part of a biomarker panel to define high-risk obesity states. The good news is that with weight loss, you can reduce chemerin levels along with the risk for metabolic syndrome.”

To conduct the study, Jialal and colleagues recruited 45 patients with early metabolic syndrome — defined as having at least three risk factors for metabolic syndrome including central obesity, hypertension, mild increases in glucose levels not yet in the diabetic range (<126 mg/dl), hyperlipidemia without cardiovascular disease or diabetes. A control group of 30 subjects had less than two risk factors for metabolic syndrome, with normal glucose and triglyceride levels. Both groups were matched for gender and age.

Complete blood counts, lipid profiles and blood glucose, blood pressure and C-reactive protein levels were measured in all participants. Levels of four proteins secreted by adipose tissue — chemerin, resistin, visfatin and omentin-1 — were also measured in plasma and in subcutaneous fat samples from gluteal tissue.

The researchers found that chemerin levels were increased and omentin-1 levels were decreased in both plasma and gluteal fat of subjects with metabolic syndrome compared to those in the control group. The abnormal levels of these two proteins were also independent of age, body mass index and waist circumference.

“Future large epidemiological studies should focus on evaluating the role of chemerin as a biomarker for the development of diabetes and cardiovascular disease in metabolic syndrome,” Jialal said.

High Fiber Diet Prevents Prostate Cancer Progression


A high-fiber diet may have the clinical potential to control the progression of prostate cancer in patients diagnosed in early stages of the disease.

The rate of prostate cancer occurrence in Asian cultures is similar to the rate in Western cultures, but in the West, prostate cancer tends to progress, whereas in Asian cultures it does not. Why? A University of Colorado Cancer Center study published in the January 2013 issue of the journal Cancer Prevention Research shows that the answer may be a high-fiber diet.

The study compared mice fed with of inositol hexaphosphate (IP6), a major component of high-fiber diets, to control mice that were not. Then the study used MRI to monitor the progression of prostate cancer in these models.

"The study's results were really rather profound. We saw dramatically reduced tumor volumes, primarily due to the anti-angiogenic effects of IP6," says Komal Raina, PhD, research instructor at the Skaggs School of Pharmacy and Pharmaceutical Sciences, working in the lab of CU Cancer Center investigator and School of Pharmacy faculty member, Rajesh Agarwal, PhD.

Basically, feeding with the active ingredient of a high-fiber diet kept prostate tumors from making the new blood vessels they needed to supply themselves with energy. Without this energy, prostate cancer couldn't grow. Likewise, treatment with IP6 slowed the rate at which prostate cancers metabolized glucose.

Possible mechanisms for the effect of IP6 against metabolism include a reduction in a protein called GLUT-4, which is instrumental in transporting glucose.

"Researchers have long been looking for genetic variations between Asian and Western peoples that could explain the difference in prostate cancer progression rates, but now it seems as if the difference may not be genetic but dietary. Asian cultures get IP6 whereas Western cultures generally do not," Raina says.

Tuesday, January 8, 2013

Diet soda, sweetened drinks linked to depression, coffee tied to lower risk


New research suggests that drinking sweetened beverages, especially diet drinks, is associated with an increased risk of depression in adults while drinking coffee was tied to a slightly lower risk. The study was released today and will be presented at the American Academy of Neurology's 65th Annual Meeting in San Diego, March 16 to 23, 2013.

"Sweetened beverages, coffee and tea are commonly consumed worldwide and have important physical—and may have important mental—health consequences," said study author Honglei Chen, MD, PhD, with the National Institutes of Health in Research Triangle Park in North Carolina and a member of the American Academy of Neurology.

The study involved 263,925 people between the ages of 50 and 71 at enrollment. From 1995 to 1996, consumption of drinks such as soda, tea, fruit punch and coffee was evaluated. About 10 years later, researchers asked the participants whether they had been diagnosed with depression since the year 2000. A total of 11,311 depression diagnoses were made.

People who drank more than four cans or cups per day of soda were 30 percent more likely to develop depression than those who drank no soda. Those who drank four cans of fruit punch per day were about 38 percent more likely to develop depression than those who did not drink sweetened drinks. People who drank four cups of coffee per day were about 10 percent less likely to develop depression than those who drank no coffee. The risk appeared to be greater for people who drank diet than regular soda, diet than regular fruit punches and for diet than regular iced tea.

"Our research suggests that cutting out or down on sweetened diet drinks or replacing them with unsweetened coffee may naturally help lower your depression risk," said Chen. "More research is needed to confirm these findings, and people with depression should continue to take depression medications prescribed by their doctors."

Red wine and green and white tea increase performance-enhancing hormone testosterone


Red wine and green and white tea could give athletes and players a boost in the sports arena by increasing the amount of performance-enhancing hormone testosterone in their bodies, according to researchers from London's Kingston University.

However not only could the beverages help them to trophy success, it could also allow them to beat anti-doping tests. A team led by Professor Declan Naughton, from the University's School of Life Sciences, found that and green and white tea might reduce the amount of testosterone excreted by the body, which could distort the findings of drug tests taken from urine samples.

Testosterone is a naturally-occurring steroid hormone present in both men and women. It can increase muscle mass, boost stamina and speed up recovery. Sportspeople, however, are prohibited from taking it, or a synthetic version of it, to try to gain a competitive edge.

Although red wine is not a banned substance away from the sports field, Professor Naughton's team has referred its findings to the World Anti-Doping Agency because of the newly-discovered side effect of potential change to the amount of testosterone in the body.

"Previous research has shown the effect over-the-counter anti-inflammatory drugs can have on enzymes," Professor Naughton explained. "Since many of these drugs are derived from plants, we decided to look at the effect particular foods and beverages can have on enzymes involved in testosterone excretion. We chose green tea and then red wine because both have a huge variety of natural molecules and we wanted to see if they affected the amount of testosterone excreted in urine."

"The catechins stop enzymes tagging molecules for excretion so the kidneys don't recognise them as needing to be removed and leave them circulating in the body," Professor Naughton explained. "We found that green and white tea could inhibit the enzyme by about 30 per cent. The levels of catechins in a strong cup of green tea matched those we used in our experiments."

The increased levels of testosterone from drinking green and white teas may provide a boost. "It's like having extra testosterone without actually taking any," Professor Naughton said. "By not excreting it from the body, athletes could potentially increase their testosterone levels for improved performance.

The team found that a compound in red wine, known as quercetin, partially blocked the action of an enzyme called UGT2B17, which looks for testosterone and then sends a message to the kidneys to excrete it.

Professor Naughton stressed that the research had so far been conducted in test tube experiments and had yet to be trialled on humans. "A full clinical study would be needed to determine the effects on people but, if the same results were found, it would confirm that compounds in red wine can reduce the amount of testosterone in urine and give a boost to testosterone levels," he explained.

The effect of red wine on an individual would vary because of factors such as weight, fitness, health and diet, making it hard to estimate how much was needed to improve performance, Professor Naughton said.

Teetotallers are not exempt from the effects. In fact, the alcohol content of red wine has very little impact because non-alcoholic molecules are responsible for inhibiting testosterone excretion.

The team also found the results were the same for red wine extract in supplement form. The active compounds such as quercetin are found in many foodstuffs as well as supplements.

The findings have been published in leading international journal Nutrition.

Saturday, January 5, 2013

Jon's Health Tips - Latest Research

Just when I start really losing weight, this report appears (which is still very good news for me!)

Being overweight associated with lower risk of death



In an analysis of nearly 100 studies that included approximately 3 million adults, relative to normal weight... overweight was associated with significantly lower all-cause mortality, according to a study in the January 2, 2013 issue of JAMA...

The researchers add that their findings are consistent with observations of lower mortality among overweight and moderately obese patients. "Possible explanations have included earlier presentation of heavier patients, greater likelihood of receiving optimal medical treatment, cardioprotective metabolic effects of increased body fat, and benefits of higher metabolic reserves."

I'm glad I take Vitamin D3:

Vitamin D Tied to Women's Cognitive Performance



Two new studies appearing in the Journals of Gerontology Series A: Biological Sciences and Medical Sciences show that vitamin D may be a vital component for the cognitive health of women as they age.

Higher vitamin D dietary intake is associated with a lower risk of developing Alzheimer's disease, according to research conducted by a team led by Cedric Annweiler, MD, PhD, at the Angers University Hospital in France.

Similarly, investigators led by Yelena Slinin, MD, MS, at the VA Medical Center in Minneapolis found that low vitamin D levels among older women are associated with higher odds of global cognitive impairment and a higher risk of global cognitive decline.

Here's a comprehensive review:

Health Benefits of Vitamin D

And two more comprehensive reviews of things I use:

Health Benefits of Aspirin

Health Benefits of Chocolate



Two for one: Information on why I don't eat hamburgers and do eat avocado:

Avocado Eaten With A Burger May Help Neutralize Interleukin-6


I don't usually link to or quote outside sources, but this review of recently published health research is too good to ignore: (I'm glad I still take fish oil, and will eat more boiled eggs

Eggs as Bad as Smoking? Vitamins Linked to Mortality? Making Sense Out of Nutritional Studies With Expert Dr. Alan Gaby


Dr. Alan Gaby: Based on the totality of the evidence, it appears that boiled or poached eggs can be an important part of a healthful diet, whereas consumption of scrambled (and possibly fried) eggs should be kept to a minimum.

PF: The benefits of another popular item, fish oil, have been questioned in a study that recently received a lot of attention in the media. Millions of Americans take fish oil daily. Doctors prescribe it. We have read about so many benefits for cardiovascular health, brain health, and anti-inflammatory benefits. Are there benefits to fish oil, specifically for heart health?

AG: The study you mentioned was a meta-analysis (pooled analysis) of 20 randomized controlled trials (including a total of 68,680 patients) that examined whether supplementing with the omega-3 fatty acids present in fish oil can decrease heart disease-related mortality or deaths due to any cause. In the pooled analysis, omega-3 fatty acids decreased heart disease-related deaths by 9 percent and deaths due to any cause by 4 percent. Because these decreases were not statistically significant, the researchers concluded (erroneously) that omega-3 fatty acids had no effect on cardiac or all-cause mortality. The correct conclusion is that omega-3 fatty acids decreased cardiac deaths by 9 percent and all-cause mortality by 4 percent, but because the effects were not statistically significant, we are less than 95 percent certain that the benefits were real (as opposed to being due to chance). Failure to demonstrate that an effect was statistically significant is not the same as demonstrating there was no effect.

Furthermore, the potential benefit of taking fish oil might be greater than the results of the meta-analysis suggest. That is because some of the studies that showed a strong positive effect were "diluted" by several flawed studies that found no beneficial effect of fish oil. One of the negative studies enrolled 18,645 Japanese patients (27.2 percent of all the patients in the meta-analysis), and therefore had a relatively strong influence on the results of the pooled analysis. The main weakness of that study is that fish consumption is high in Japan. The protective effect of omega-3 fatty acids against heart disease can be obtained with relatively low doses, and little or no additional benefit can be achieved by increasing the dose. Consequently, one would not expect fish oil supplementation to reduce mortality in this population where fish consumption is high. In another negative study included in the meta-analysis, olive oil was used as the "placebo." Olive oil is a known cardioprotective agent, so the fact that fish oil was not more effective than olive oil does not mean fish oil was ineffective.

I'm glad I have started to drink coffee but I'm not quite up to "moderate" consumption yet and certainly not than 4!

Moderate coffee consumption may reduce risk of diabetes by up to 25 percent


Drinking three to four cups of coffee per day may help to prevent type 2 diabetes.

More than four cups of caffeinated coffee reduces the risk of oral cancers

A new American Cancer Society study finds a strong inverse association between caffeinated coffee intake and oral/pharyngeal cancer mortality. The authors say people who drank more than four cups of caffeinated coffee per day were at about half the risk of death of these often fatal cancers compared to those who only occasionally or who never drank coffee.

Not good news - my business-related stress is way up this year:

Perceived Stress May Predict Future Risk of Coronary Heart Disease


27% increased risk for newly diagnosed heart disease or death among those with high perceived stress

Are you stressed? Results of a new meta-analysis of six studies involving nearly 120,000 people indicate that the answer to that question may help predict one’s risk of incident coronary heart disease (CHD) or death from CHD.



These reports are encouraging (I scored an 8) although I'm not sure how long into the future I can keep either up:


Ability to sit and rise from the floor is closely correlated with all-cause mortality risk



The test was a simple assessment of the subjects' ability to sit and then rise unaided from the floor. Before starting the test, they were told: "Without worrying about the speed of movement, try to sit and then to rise from the floor, using the minimum support that you believe is needed."

Each of the two basic movements were assessed and scored out of 5, with one point being subtracted from 5 for each support used (hand or knee, for example). Subjects were thus assessed by a composite score of 0 to 10...

A composite score below 8 (that is, requiring more than one hand or knee support to sit and rise from the floor in a stable way) was associated with 2 fold higher death rates over the 6.3 year study period. By contrast, scores in the range of 8 indicated a particularly low risk of death during the tracking period.




Aerobic exercise boosts brain power in older adults


Studies in older adults reviewed by the authors consistently found that fitter individuals scored better in mental tests than their unfit peers. In addition, intervention studies found scores in mental tests improved in participants who were assigned to an aerobic exercise regimen compared to those assigned to stretch and tone classes.

In older generations, the evidence for improvement in cognitive function is insurmountable. The types of tests of cognitive function reviewed here are important in showing that exercise may attenuate age-related decline for specific tasks. For example, it has been found to positively affect mental tasks relating to activities such as driving, an activity where age is often seen as a limiting factor.


More interesting research:
Healthy lifestyle during menopause may decrease breast cancer risk later on

Yellow and orange pigmented vegetables decrease hip fracture risk

Alli Strongly Alters Other Drug Therapies

Statins = improved survival in inflammatory breast cancer


Aerobic exercise trumps resistance training for weight and fat loss

2 cups of milk a day ideal for children's health, new research shows

Wednesday, January 2, 2013

Being overweight associated with lower risk of death


In an analysis of nearly 100 studies that included approximately 3 million adults, relative to normal weight, overall obesity (combining all grades) and higher levels of obesity were both associated with a significantly higher all-cause risk of death, while overweight was associated with significantly lower all-cause mortality, according to a study in the January 2, 2013 issue of JAMA.

"Estimates of the relative mortality risks associated with normal weight, overweight, and obesity may help to inform decision making in the clinical setting," according to background information in the article.

Katherine M. Flegal, Ph.D., of the National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md., and colleagues conducted a study to compile and summarize published analyses of body mass index (BMI) and all-cause mortality that provide hazard ratios (HRs) for standard BMI categories. For the review and meta-analysis, the researchers identified 97 studies that met inclusion criteria, which provided a combined sample size of more than 2.88 million individuals and more than 270,000 deaths. Regions of origin of participants included the United States or Canada (n = 41 studies), Europe (n = 37), Australia (n = 7), China or Taiwan (n = 4), Japan (n = 2), Brazil (n = 2), Israel (n = 2), India (n = l), and Mexico (n = l).

All-cause mortality HRs for overweight (BMI of 25-<30), obesity (BMI of ≥30), grade 1 obesity (BMI of 30-<35), and grades 2 and 3 obesity (BMI of ≥35) were calculated relative to normal weight (BMI of 18.5-<25).

The researchers found that the summary HRs indicated a 6 percent lower risk of death for overweight; a 18 percent higher risk of death for obesity (all grades); a 5 percent lower risk of death for grade 1 obesity; and a 29 percent increased risk of death for grades 2 and 3 obesity.

The authors note that the finding that grade 1 obesity was not associated with higher mortality suggests that that the excess mortality in obesity may predominantly be due to elevated mortality at higher BMI levels.

The researchers add that their findings are consistent with observations of lower mortality among overweight and moderately obese patients. "Possible explanations have included earlier presentation of heavier patients, greater likelihood of receiving optimal medical treatment, cardioprotective metabolic effects of increased body fat, and benefits of higher metabolic reserves."

The use of predefined standard BMI groupings can facilitate between-study comparisons, the authors conclude.